Comparison of physical function in early rheumatoid arthritis patients treated with biologics for 1 year who achieved clinical remission or low disease activity

This study aimed to evaluate whether targeting clinical remission is appropriate for suppressing physical dysfunction in patients with early rheumatoid arthritis (RA). Subjects were all 75 early RA patients (within 2 years of onset) who were continuously treated with biologics for 12 months at our hospital. We evaluated the Simplified Disease Activity Index (SDAI) and Disability Index of the Health Assessment Questionnaire (HAQ-DI) at 3, 6, and 12 months from the initiation of biologics therapy. Rates of functional remission (HAQ-DI ≤ 0.5) at 12 months in the clinical remission (SDAI ≤ 3.3) group and the low disease activity [LDA (3.3 < SDAI ≤11)] group were 97 and 86%, respectively. Multivariate logistic regression analysis revealed that duration of disease and SDAI at 6 months were significantly associated with the achievement of functional remission at 12 months. The best cut-off value of SDAI at 6 months for predicting functional remission at 12 months was 15.7 by receiver operating characteristic curve analysis. HAQ-DI scores in the LDA group were significantly higher than those in the clinical remission group at 6 and 12 months. The mean HAQ-DI score at 12 months in the clinical remission group improved significantly relative to the mean HAQ-DI score at 6 months in the LDA group. Our findings highlight the importance of achieving LDA at least by 6 months after initiating biologics therapy, and achieving clinical remission as soon as possible, in order to minimize physical dysfunction in patients with early RA.